Abstract
BACKGROUND: Psychological stress may influence health by negatively affecting dietary intake. However, there are few studies on the connection between stress and dietary intake in Puerto Rico (PR), a population with documented poor diet quality. OBJECTIVE: To explore the association between perceived stress and intake of macronutrients and diet quality among adults in PR. DESIGN: Cross-sectional data came from the Puerto Rico Assessment of Diet, Lifestyle, and Diseases study (2015). PARTICIPANTS: This analysis included data from 238 adults (30-75 years old) in the San Juan metro area. MAIN OUTCOME MEASURES: Dietary intake was measured with a food frequency questionnaire adapted and validated to the PR population. The Alternate Healthy Eating Index (AHEI) score was calculated to measure diet quality. STATISTICAL ANALYSES: Multivariate linear models adjusted for sociodemographics, anthropometrics, behavioral factors, and social support were used to determine adjusted mean macronutrient intake and AHEI scores by perceived stress category. RESULTS: In models adjusted for sociodemographic characteristics, high perceived stress was significantly associated with higher intake of total energy, added sugars, and saturated fats; lower intake of dietary fiber and vegetable protein; and lower AHEI score compared with low perceived stress (all P < .05). With further adjustment for lifestyle behaviors, central obesity, and social support, high perceived stress remained significantly associated with added sugars, saturated fats, and vegetable protein only. CONCLUSIONS: Higher perceived stress was associated with unhealthy dietary intake in adults residing in the San Juan area, PR. Future longitudinal studies with larger sample size are needed to build on these findings and to test the potential mediating and moderating roles of behavioral and social support factors in this population.